45 - 50% Weight Loss w/ Band?

[MCOBandita 0]

Today I attended a consultation at my Doctor's office and was told that only 45 to 50% of people who have the Lap-Band done lose any weight. The nurse practioner said that their specific patients have had a 50% success rate. These figures seem very discouraging to me. :phanvan

When I questioned him as to why only 50% lose weight he said that people cheat/cannot overcome the emotional or mental obstacles they need to overcome to change their lifestyle. He went on to state that he thinks the figure is 50% because some patients who have BMI's in the 50-60 range have elected to have the Lap-Band and have not been successful, which he feels skews the results. We briefly discussed my health and eating patterns and he feels that since my weight is based more on the quantity of food I eat vs. eating foods which in the future would be cheating foods (ice cream, shakes, etc.) that I would be an "ideal candidate." I find it hard to believe that all of these people cheat after going to the expense/physical demands pre- and post-op to cheat that dramatically. He even stated that they have a patient who has only lost 5 pounds in a year. I asked him specifically what he would do if someone was not losing any weight and was not cheating. He said that he would not tighten the band - that he relies on a more conservative approach and leaves the band more open to "make more of the brunt of it rest on the patient's shoulders."

I am feeling very discouraged and misled by the information that I was given previously my the actual Doctor - I was told the success rate was more like 70%, with loss averaging 1 pound a week. However, the nurse practitioner will be in charge of all of the fills and if his approach is overly conservative it will affect my progress.

I am self pay and am feeling very hesitant about committing myself to payments of about $350 a month for the next 5 years for something that might not even work for me. I believe that I can commit to eating the right foods, however, the major benefit of the bad to me is the idea that it restricts the amount of food I eat. I worry that if the nurse practioner leaves the band to loose, I believe I will not obtain the benefit I am looking for.

Has anyone else been given this type of success rate by their Doctors? Please help, I am feeling confused! Any advice would be appreciated!

~Sara

[Wheetsin 714]

Well, first of all when your surgeon says "50% success rate", how is that meant?

a) 50% of the people who have the surgery meet the medical criteria for success.

100% of his patients lost 50% of their excess weight, or numbers that bring in the same average.

c) Judging by some criteria he has assigned, some combination of a or b?

It's very easy to not lose weight with the band if you're not focused on losing weight. And it's very easy to not focus on losing weight, and use the band as an excuse for that.

Think of all the things that make it easy to bypass the band, and you'll see where those numbers might be coming from. E.g. people who never get a fill because they're afraid that would mean they have to give up foods. Or people who use cognitive distortions to get out of good eating habits. Or people who go underfilled and try to "wing it", but then never go after the fill to take off where their willpower left.

Hmm, my starting weight was 382 with a goal weight of 180. Right now I'm right around 255, so I've lost about 63% of my excess weight. That's since March 1, so about 11 months, and includes about 5 months of being underfilled and 3 weeks of being almost wide open (to make sure I'm thoroughly healed from an overfill). So I would really question this statement:

He went on to state that he thinks the figure is 50% because some patients who have BMI's in the 50-60 range have elected to have the Lap-Band and have not been successful, which he feels skews the results.

Pople of ALL BMIs have elected to have the lapband and not been successful, so why would he attribute it to those in the 50 - 60 range? Argh, that irritates me. But regardless - sounds like he's kind of pulling his numbers from nowhere. If you care to, press him and ask him what these numbers really mean.

Beyond that, do with what you feel is the right decision for you. :rose:

[enterprise01 0]

My doctor said 15% of lap-band patients will fail with the band because they will find ways to defeat it, i.e., eating ice cream, shakes, etc. I believe he also said that a majority of patients will only lose about 50% of their excess weight. When I had my one-on-one consult, he very specifically asked me if I would be able to accept that the band might only help me lose 50 pounds, instead of the 98 that I want to lose. I believe that the band will work for me and that I will lose more than 50 pounds. Statistics are not a crystal ball. If you are determined, you will succeed. I refuse to be part of that 15%.

[lisah25 3]

I asked him specifically what he would do if someone was not losing any weight and was not cheating. He said that he would not tighten the band - that he relies on a more conservative approach and leaves the band more open to "make more of the brunt of it rest on the patient's shoulders."

I believe this is a key. The band is a tool. As such, it needs to be turned on/plugged in to work. That means filling it correctly. It sounds to me like this doctor doesn't do so. If someone isn't cheating, and isn't losing weight, what the heck does he expect them to do?!

Ok, rant over. What I do like about the band is that I feel I have a HUGE say in how sucessful I am.

[ousooner 1]

I think Wheetsin hit it on the head. I have always heard that the 50% success rate was that patients loose on average 50% of there body fat, not that only 50% loose any weight. I would question your doctor. There is a percantage of people who don't loose. That goes with any WLS. It is a tool and not a cure. Remember too that the 50% (and I honestly beleive that percentage is higher than that if my memory serves) counst those that don't loose and weighs down the average loss.

[Jachut 487]

Well, what he says is probably true to some degree, where there's a large emotional or compulsive eating type of behaviour, I guess the lap band still slows you down but you have more work to do than somebody who's really only a volume eater.

I was pretty much a volume eater and the band has worked brilliantly for me. But I do have to use significant willpower and self control to mainly eat good healthy foods and stay away from junk. I mean, who isnt prey to the convenience of take away and junk foods in today's society? Its the lifestyle we live and that takes some overcoming.

I also exercise hard and often. The band doesnt make me do that.

So you do have to find within yourself the things you need to work with this tool and not everybody can do that, but I think his stats are awfully pessimistic, I think you'll find people are happy with varying degrees of loss and regaining control over thier lives!

[enterprise01 0]

....People of ALL BMIs have elected to have the lapband and not been successful, so why would he attribute it to those in the 50 - 60 range? Argh, that irritates me. But regardless - sounds like he's kind of pulling his numbers from nowhere. If you care to, press him and ask him what these numbers really mean.

It seems that most of the studies focus on the first 12 to 18 months of being banded. If you haven't reached your goal by 18 months, you're probably considered a failure for the purposes of the study. If you have a higher BMI, it will take longer to get to goal, so I can see why the doctor would say that people with higher BMIs skew the stats if they are only looking at 12-18 months post banding. Statistics can be very misleading, and it's important to understand the criteria on which the data was collected before you put any credence into those numbers. Wheetsin was totally right -- ask the doctor what those numbers really mean; make him explain in more detail.

[MCOBandita 0]

Thanks everyone for your replies! Everything you said makes sense to me. This particular Doctor is considered the best in my metro area so I am most comfortable going to him for the surgery. After reading LisaH's comment I think I should go ahead and have the surgery with this doctor and then if the nurse practitioner isn't aggressive enough with the fills then maybe I will go to another doctor's office to have fills. Of course, I would speak to my doctor first if these concerns arise.

[MCOBandita 0]

Well, first of all when your surgeon says "50% success rate", how is that meant?

a) 50% of the people who have the surgery meet the medical criteria for success.

100% of his patients lost 50% of their excess weight, or numbers that bring in the same average.

c) Judging by some criteria he has assigned, some combination of a or b?

I believe that he meant a) only 50% of the patients meet his criteria of success.

Hmm, my starting weight was 382 with a goal weight of 180. Right now I'm right around 255, so I've lost about 63% of my excess weight. That's since March 1, so about 11 months, and includes about 5 months of being underfilled and 3 weeks of being almost wide open (to make sure I'm thoroughly healed from an overfill).

WOW, you have done GREAT! Congrats! :clap2:

If you care to, press him and ask him what these numbers really mean.

I will, thanks for the advice!

[Wheetsin 714]

When I had my one-on-one consult, he very specifically asked me if I would be able to accept that the band might only help me lose 50 pounds, instead of the 98 that I want to lose.

Beautiful! Truly! And that's what I said when I made my decision - I'm going to beat the statistics. Because there's no way I'm going to volunteer for my first surgery (*ahem* Wheetsin has a mild needle phobia) and have it be for nothing.

Would I WANT to be 160? Umm... maybe. 160 is pretty skinny for me (I'm close to 6 feet tall). I would crap my pants if my scale ever said anything under 200. Which is a good thing, because then - after I changed into clean pants - I would weigh that much less.

230 - 240 is the last time I felt comfortable with myself. I was probably 30 - 40 lbs overweight at that time. (C'mon, I'm almost 6 feet tall here!) I told my psychologist that I'll be thrilled with anything between 190 and 210, but that ideally I'd hit 180. He seemed pleased with that.

Also, I may well be wrong here, but I thought that sometime somewhere I read that the lap-band success rates included long-term patients, including those who had their bands removed. But I can't remember where I read that, so consider me a big fat liar.

[Chickie 15]

I always took the studied EWL % to be everyone's EWL added together, then divided by the number of people.

Example;

Jane has 99% EWL

Dick has 45% EWL

Mary has 76% EWL

Frank has 25% EWL

99 + 45 + 76 + 25 = 245 / 4 = 61.25 % average EWL

So while some do really, really well (Jane's 99%) the lower numbers in the study bring the average down.

I might be wrong.

[RLittman 4]

I was told the same thing by my doctor. He asked if I would be satisfied with possibly only losing 50% of my goal weight by the end of the first year. I said yes because I would have been happy losing anything. As luck would have it, I lost 50% of my goal weight within 6 months and I am thrilled to be down 42 pounds. My blood pressure and all blood work is now normal whereas just last August my HDL and LDL and triglicerides were all high and I was pre-diabetic. I can now exercise normally and am down to size 14-16 clothing.

You can cheat with the band because human nature is human nature. I do not intend to stop eating, just to eat proportionally less. I still want to eat things that taste good but the band stops me from eating too much so that I don't regain the weight I have lost. I use it to both to lose weight and maintain. Last night I had a piece of chocolate because I was hungry and I wanted a sweet, but I did not eat 1/2 a box which I could have done before because my appetite was so much larger.

The band is a tool not a solution and you will still have to change your lifestyle and eating habits to make it work. Your doctor is giving you a reality check that is in your best interest to hear, i.e., that the band will not work for you unless you work with the band. I have a friend for whom the band was not helpful because she wanted to eat whatever she wanted to eat whenever she wanted to eat it. Unfortunately, the band got in the way of her lifestyle. I decided to change my lifestyle and let the band help me lose weight. It was the best thing I ever did.

[MCOBandita 0]

As a follow up - even though the Nurse Practioner had said that I would be an "ideal candidate" for Lap-Band they have since changed their minds. Because I asked questions about the discrepancy between the information I was provided with at the seminar (70% success vs. 45-50% success) they have decided that they will not perform the sugery on me. Because I specifically said that I felt that the information seminar had been misleading and in conflict with what I was later told they said that they "believed that a relationship with a patient had to be established on a more positive note". I was pretty shocked. I mean asking questions about what I can realistically expect made them think I should be denied as a patient? I am just trying to be as informed as possible before I invest a total of about $18,000 in this surgery! I guess most people walk in there with no questions or concerns? Geez! Sorry for trying to obtain clarification about such an important decision!

[ousooner 1]

Wow, that is shocking. I don't know what to say. Sorry you experienced that kind of reaction. It may be a good thing as if a doctor is not confident in himself or his information, I don't know if I could trust him to operate on me.

[lisah25 3]

As a follow up - even though the Nurse Practioner had said that I would be an "ideal candidate" for Lap-Band they have since changed their minds. Because I asked questions about the discrepancy between the information I was provided with at the seminar (70% success vs. 45-50% success) they have decided that they will not perform the sugery on me. Because I specifically said that I felt that the information seminar had been misleading and in conflict with what I was later told they said that they "believed that a relationship with a patient had to be established on a more positive note". I was pretty shocked. I mean asking questions about what I can realistically expect made them think I should be denied as a patient? I am just trying to be as informed as possible before I invest a total of about $18,000 in this surgery! I guess most people walk in there with no questions or concerns? Geez! Sorry for trying to obtain clarification about such an important decision!

This could end up being a really good thing, you'll find a surgeon who has a better understanding of the band and what it does.